HomeMy WebLinkAboutX2021-2877 - Permit ApplicationRalntisrm ` Wo sheet for Combo Building &Solar Permit Application
r Comm'I [F Residen a City of Newport Beach - Building Division O `h
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL V( 01I
I-Vtuilding f— Grading f—Drainage r�_�Elec ch r Plum CuYdCut F CuYdFill F
Project Address (Not mailing address) r Flood F Fire r Liq I— Landslide rN/A Floor Suite No
Description of Work
Use F—Const Type F_
2`t Gv fitC i� H 3 {lE/"- rL7.v5. ��`c h. i �C t 'C r�'� It la
# Stories #Units (if Res.
�E/��,Mt4Cm��
_. _ _.. ...... _......
Valuation 5
Material/Labor Jr �L,r C'C�O
New/Add SF eat � .�_ + Remodel SF.[ Garage/New/Add �—_
OWNER'S NAME Last tj"�t�':IL'�=YL First /jr9774
Owner's Address Owner's E-mail Address
C.4—/ 17Z, 4 /),' i v
city revei.��gr'%-!��NG'/y'... State F e -t zip `/26773Tele hone /
-,. P 4S`iS 7/lam
APPLICANT'S NAME Last jj�I"_tctNZ First l It-,q
Applicant's Address _ Applicant's E-mail Address
L4-.6)i 11479Li:'Uq Ol21vE sRf'N.ZJrl-,Co."L
City /V�"i�tr'J/= I r�r9C /174 j
.... State Zip_ %ZED ... Telephone
ARCHITECT/DESIGNER'S NAME �r y
Last i EC First I Lic No.F__
Arch itecUDesigner's Address Architect/Designer's E-mail Address
C"% LX�jf 4-5 I '', �G� c;.� rG.�E�,l,�c: v2�_ C•O,^-)
City G-.ffi�t F7i�tL7cJirE-�ll State ( 4... Zip..c�/7'SC'% Telephone%�'�>' �4-/ �%CiC7LL.....
ENGINEER'S NAME Last .Mti-i"First F7A SON Lic.No.L'225`,•
Engineer's Address Engineer's E-mail Address
i' C' ,3o,< 7.-714 _... .StateFT
E City Foi._a ..� 4 Zip F7j7ZS ;7.? Telephone!`%$I Z�iS C�,7E
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CONTRACTOR'S NAMEXOMPANY �5 L-�� •,.ate � �5 ' � ,� 5- Lic. No. Class?—.
Contractor's Address - Contractor's E-mail Address
City l2VvwC State L'? -- Zip `TZLCSC'. Telephone 4_9 77 cl7.5
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SETBACKS REAR -: ��� SETBACKS FRONT 4 (i, r % PERMIT NO. iA s
SETBACKS LEFT 7 r SETBACKS RIGHT / S FT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES S
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